Keeping The Girl Under Her Doctor’s Orders

When the curtain was next whisked back the girl barely blinked. The doctor was suddenly standing there hands on hips dressed in her customary hip-hugging black leather skirt, her tailored satin blouse reflecting the ward strip-lights in deeply-bedded glossy pools, its pearl buttons near submerged between an impressively high and well-defined bustline. Lavinia having succumbed to a sort of self-hypnosis, her eyes fixated on the endlessly rippling plain of green plastic drapes, it took a few moments for any kind of spark of awareness to flicker back into the teenager’s eyes. Bending and tucking her fingers under the girl’s chin, lifting it and bringing her patients gaze to meet her own, the doctor smiled at the glazed, cloudy distant look in her patient’s eyes. The hint of incomprehension that still lingered on the girl’s face, and that seemed reluctant to totally clear, pleased the statuesque woman. Still bending she twisted to look back over a shoulder at the Ward Sister who had come across to stand beside her:

“She is becoming quite withdrawn: it’s taking her quite a while to snap out of it. I’d say she was coming along quite nicely - the young woman you’ve put in charge of her really knows her stuff; she should be congratulated.”

Then, turning back to the rapidly more responsive teenager, the girl’s eyes now flickering back and forth as if in fright and her cheeks colouring, the doctor addressed her directly:

“And how about you, how do you think you’re getting on in your new home? You going to be here with us a very long time don’t forget. Do you think you’re settling down, now - would you say that you’re settling down to becoming a nice co-operative, docile mental patient? Because I think you are - as you just heard me tell the Ward Sister here; I think you’re well on the way to becoming a proper psychiatric patient, the sort of case that I should have no problem in convincing the review board when the time comes to leave in my hands for a further five years. Would you think about that? By the end of that period you will have been in this establishment, in one way or another, for over nine years - not far off ten, as a matter of fact.”

Helped to her feet by a hand placed beneath her elbow, she was led by the hand, escorted by the Ward Sister, shuffling up the narrow aisle formed between the iron-railed bed frames - each numbered at the foot and surmounted at the head by a wall-board detailing the occupant’s various diagnoses as if detailing the heinous deeds carried out by a justifiably-incarcerated criminal kingpin. In a step-synchronised disciplined procession, like a well-rehearsed wedding march, they moved as one; the stylishly attired doctor to the fore, the starch-uniformed Ward Sister to the rear now guiding young Lavinia with both hands laid upon the latter’s bowed shoulders. Coming to the rails of the security gate at the far end of the ward, the Ward Sister removed the padlock, keys tinkling and ringing discordantly in the silence of the ward, ushering them through.

The room beyond, as always, was filled with the same disinfectant smell that permanently infected the tiny secure ward and that she could still remember wafting along the entire length of the winding labyrinth of corridors that lay outside the padlocked ironwork security grille and the locked double doors of the ward’s entrance. The latter was a cumbersome arrangement to be sure; an airlock-like porch spanned by a barrage of prison bars and having a reception desk set back off to one side invariably staffed by a stone-faced and grey-haired wardress-like woman who controlled the comings and goings through the authority of the steel ring of bright jingly keys that swung from a leather tab sewn into her calf-length navy-blue serge uniform dress. The ironwork gate served to separate the inner from the outside door - both of which were in themselves substantial and kept locked - and had its clunky integral iron block lock rather unnecessarily augmented by a heavily armoured modern case-hardened steel padlock. Negotiating three such secured doors and four separate locks each time passage was required to or from the ward was a source of constant annoyance and irritation to the staff. It was of some relief, then, that it was rarely necessary to move patients around.

Once a patient was securely ensconced that was all there was to it - she would be fed in her bed, washed down by sponging, either standing by her bed or bent across it and toileted on a bedpan placed on the bedside chair. The latter, ironically, would take place with the curtain drawn back; this being officially so all patients might be supervised throughout their ablutions by a single nurse or the Ward Sister strolling up and down between the ends of their beds. Unofficially, this withdrawal of privacy had as much to do with the continuously on-going process of proving to these young women and reinforcing the idea that their lives were no longer their own and that they no longer had any control over any part of their existence, no matter how trivial.

Of course an even greater irony was the fact that the closing of the curtain around a patient’s bed came to be seen in time as a punitive measure, a simple and effective way of distancing her still further from the real world, denying her even that limited, shallow social contact she would ordinarily be allowed with her fellow mental patients. Some mingling was allowable in the central aisle between the beds. Conversations could take place in quiet hushed timid little voices - little more than a whisper was tolerated - but always had to be within earshot of the supervising nurse. There could be no secretive huddles in corners and the subject matter of their chatter was closely monitored - only the most trivial, mundane aspects of ward life could be discussed. Symptoms and signs of mental illness, whether their medication left them woozy or woolly-headed, how much they were looking forward to the next group therapy session and how beneficial they found it, whether or not the new suppositories were helping their bowel movements - these were all deemed suitable subjects for gossip.

Anything pertaining to the world at large, anything relating to their previous life or loved ones left behind outside, anything philosophical or critical, could lead to punitive repercussions. Even idly wondering out loud what day of the week it might be or whether or not it might be sunny outside could invite punishment.

The idea was that they should come to consider the world outside as no longer existing as far as they were concerned, that this small compact ward and the psychiatric wing in which it resided was now the entirety of their existence and that their conversation should both reflect that fact and serve to constantly remind them that they were now just mental patients whose points of view and ideas were no longer of interest to anyone.

A patient who as much as mentioned her name could find herself confined to bed in full restraints with the curtain drawn around. Indeed this was considered a particularly heinous crime and one that would also be punished in addition by a good few swipes from the Ward Sister’s cane or the doctor’s riding switch across her bare behind. Patients had their case designation numbers boldly printed on their striped green and white pyjamas which in turn they were taught to think of as a form of uniform and that as such should in time come to define their personality. Names were something that had been left outside the hospital gates, dumped along with their normal clothing, mobile phones, credit cards, identity papers and all the other clutter they might once have thought of as their ‘personal effects’.

It didn’t matter whether she had once been a homeless street waif, a highflying board member on her way to the top - used to wanting the best and getting it and who had arrived in the latest designer business attire - or a once-headstrong teenager who had been brow-beaten back into school uniform by an overbearing aunt. The long drawn-out admittance procedure was calculated to bring them all down to the same level, breaking them down both emotionally and psychologically well before they got anywhere near the actual long-term secured ward. Hair would be chopped back to the regulation hospital length and colour bleached out if dyed - the latter leaving it with no more lustre than straw. Nails would be clipped, eyelashes trimmed and both eyebrows and pubic hair shaved.

Each would have been marched through into the secure wing stark naked; invariably following on from their first experience of institutional corporal punishment. Only once behind the locked gates of the secure psychiatric wing would they have received their patient uniform - lovingly designed to complete the task of robbing them of their dignity - before then being taken the rest of the way, as Lavinia had been, in a specially designed restraint-wheelchair with their eyes and ears covered. Once they were finished with them even the most stubborn of these young women would have timidly followed the nurse though those double locked doors and the prison bar gate to her new home.

Here, on the ward, they were encouraged to foster a new personality: one suited to, and accepting of, long-term incarceration and that was best represented by a pair of digits rather than a name. By this they would now be known and addressed by members of staff and it was by this that they were obliged to refer to themselves or to other patients - nothing else.

This room, leading directly off of the ward proper though separated from it by the obligatorily-padlocked iron-bar gate, contained everything else thought necessary for the care and incarceration of female psychiatric patients thus freeing the staff of the burden and the security issues involved in ever having to move a patient back out of the triple whammy of security that was the ward entrance. Far larger than the ward itself - occupying perhaps three or even four times the latter’s floor area - this space ironically known as the ‘recreational area’ had neither windows nor any exit, save that leading through into the more intimate private confines of the ‘one-to-one consultation room’.

Having passed reverently through the hinging, vertically-barred gate, guarding the end of the ward furthest from the entrance point it was towards this so-called ‘one-to-one consultation room’ which Lavinia was now guided by her hand, feeling as if a small child. They entered via a doorway ordinarily kept locked fast but that today awaited for them ajar. The thick, sound-dampening sandwich of dense oak flanked on either side by alternating layers of rock-wool cladding and soft but tough, quilted plastic stuffed with acoustic wadding was certainly heavy, yet swung effortlessly inward on well balanced hinges when pressed allowing the group to progress through to the sparsely appointed, softly-lit space beyond.

Other than the point of entry through which they had just passed, one solitary door existed here, lying back inset within a side wall: More often than not, this would be left deliberately ajar as a not-too-subtle salutary warning of just some of the repercussions of disobedience and of the scope of the remedies open to such an institution such as the one in which Lavinia now found herself. The interior padding of this door, notably thick, could be plainly seen and enough of the brightly-lit interior of the space behind to form an impression of a padded cell such as she had seen in films and in pictures, but scaled more along the lines of a walk-in cupboard, such that an occupant would have insufficient space to stretch out and would be obliged, therefore, to sit with a perpetual bend in the knees. She’d been placed in a room such as this before: every surface covered with thick plasticy padding and a floor that felt as if standing or sitting on a deep soft bed mattress that just extended down for ever, bottomless and swampy textured.

Directly abutting this doorway stood a double-fronted wooden cupboard with one door carelessly left swung aside revealing a rail from which hung an entire row of canvas straitjackets of the type she had been forced to walk into the ward wearing on her very first day. The message was clear enough - and she knew there would be more to it than merely the discomfort of being trussed in the jacket and forced into the muscle cramping space of padded ‘little ease’. There would be some other, psychological, torment to augment the effect of the punishment - there always was; they always punished both the body and the mind. It could well be child’s nursery rhyme played over and over twenty-four hours a day or something as simple as a continuous metronome-like ticking or irritating cricket-like chirruping or even a recording of her own voice, perhaps reciting some formula castigating herself or assuring herself that she was indeed mentally ill and a mental patient in need of care. That was the point of the exercise after all; that one day she would, with the doctor’s loving guidance, become exactly that - a mental patient.

On her immediate left, set up in the corner, squatted a blackboard and easel and set before that were a pair of small, cramped wood and wrought-iron school desks, looking as if taken straight from some Victorian schoolroom museum exhibit. To the right lay the interview table, a plain white table set with a comfortable padded reclining office chair for the interviewer or councillor behind and with two straight-backed plastic chairs arranged to the front where ordinarily there would be one.

But it was with the two school desks that the real surprise awaited: one of the two under-sized, cramped child-proportioned desks was already occupied! The hapless young woman seated there was readily recognizable to Lavinia as ‘patient 09’ - partly from recall, as the poor sleep-deprived young thing she had encountered on her first day on the ward, tottering unsteadily in the corner while all around her slept cruelly soundly, but mainly through the numerals printed boldly across the rear of the latter’s restraining straitjacket.

An identically-stiff canvas and leather garment lay folded on the vacant seat - identical that is in all but the numerals displayed fore and aft, in this case a ‘three’ and a ‘zero’, 30: young Lavinia’s designation in this institutionalised world.

“Slip your arms into the sleeves, please, child,”

The straitjacket, that most humiliating symbol of mental incompetence, had been plucked from the plastic chair by it shoulders and was now being proffered towards her as casually as might a department store shop assistant have once offered up to her the latest thing in zeitgeist styling - once, long ago... once when she had been free. Mind you, there was a price to be paid for freedom: back then she would have had to stand before a full-length mirror and there would have been a decision to be made. At least nowadays she was spared that particular trial - apart from one option... and that was not one she would be likely to opt for.

Decisions were the outcome of equations balanced by benefits and sanctions, a seesaw weighing of advantages against consequences. The latter lay across the desk behind the slowly rotating spiral disc device, the pliant switch still droplet-strewn by the pickling brine solution in which it was stowed and that kept it supple. The former - the jacket - if not pulled so tight that the shoulders burnt and one’s breathing became laboured - Lavinia knew from experience, could be less of a torture and more of a release; the restriction ironically giving rein to a freeing of the spirit... or at the very least, a surrender of responsibility... If not for that latter point it was a ‘no-brainer’, but surrender of responsibility was the credo here - it was exactly what was wanted of her, of all the poor cows they kept locked-up on the ward.

Arms pulled across and under her pendulous bosom she felt the now familiar security of butterfly straps and buckles fastened up the rear, then the satisfaction of the crotch strap dragged between her legs and relieving her of the unrelenting responsibility of hitching up pyjama bottoms robbed of draw-strings and baggy rubber bloomers that had never so much as conceived of elastic waistbands. Now rendered refreshingly helpless she found herself dumped down alongside her idiotically grinning erstwhile compatriot and facing the blackboard and the insistently flickering vivid black and white disk that slowly spun on a bracket attached to the rear of the desk.

Like some rotational representation of the 1960’s artist, Bridget Riley’s, sensorially-challenging work, the latter could neither be ignored nor tolerated. It was not the first time Lavinia had been confronted by this apparition - one glance had informed her of that - but how many other occasions had there been, how often? That knowledge had been stolen from her in some way, of that she was certain.

Though on the surface - and given a cursory glance - monochrome, to the habituated viewer dazzling, bright, vibrant colours danced in spectacularly pulsating choreography between the interweaving spirals of densest inky-blacks and stunning fluorescing whites. The ever-shifting patterning drew the eye to its centre, dissolving conscious thought, captivating the mind with its staggeringly beautiful vibrancy and stealing reason. Here was something to be wary of, just as she felt she had been wary of it so many times before - yet she was unsure quite why. There was no way she could take her eyes off the display; whatever thoughts she had it quickly claimed for itself - and what determination she still held only served to draw her eyes inexorably toward the waiting cane... The thought of its brine-pickled suppleness whipping back and forth across the taut fatty globes of her naked behind terrified her. Nonetheless; deep down inside she felt she should still struggle - though she was no longer at all sure exactly what she should be struggling against.

Somehow she blinked, mentally swimming against the whirlpool tide seeking to drag her down to its infinitely mindless depths.

“No, please, no! What is this?”

The reality was not quite so clear, her clarity drowned by the stutter that now crippled her speech - her straightjacketed companion stared on blankly regardless, as if she had uttered nothing.

The doctor’s voice maintained her usual note of patronising patience as she stepped forward to deal with the situation. This was nothing untoward; indeed, had there not been at least some modicum of defiance she would have been far less certain of her subject’s progress than she was - and as it was, she was delighted.

“Silly girl - have you any idea how often have we been through these sessions together? ...You can’t remember, can you? Well, why should you, I suppose?

Yes, today is the first you will have shared with your fellow newcomer here - but we have had countless sessions together before this. In a moment I will offer you a dose of the tranquilizer you are customarily given on the ward; the only difference being that the dose will be a little stronger. At this sort of concentration, the narcotic I have prescribed has the side-effect of inducing short-term amnesia. Ordinarily disadvantageous and to be avoided this effect is also accompanied by the frankly, rather advantageous, induction of an increased level of suggestibility in the subject.

If you look across the room, there, you will see a blackboard, a standard schoolroom blackboard. On it, if you look, you will see sketched-out what appears to be a children’s hangman game... Recognise the handwriting - hmmm?”

Lavinia did indeed - it looked frighteningly like her own! But some of the letters... They looked to spell out the name of her first pet - all but the first letter or so, a puppy it was...no it was a cockatoo, wasn’t it? Or was it a, a,a... Well, she knew the name - it was Bl... no, not that...the first few letters were missing...it was... She had to think....but her head throbbed so...

“Would you like one of these, dear?”

The doctor’s outstretched hand unfolded from around its cargo of glistening gold and green pleasure - tranquilizers, the golden panacea of many a hospital mental ward. Reluctantly Lavinia found herself with her pretty head craning forward, lips puckered and sucking hungrily at the brace of encapsulated drugs nestling in her mind-mistress’s palm.

“Want these? Well, of course you do. And why shouldn’t you, a mental patient trapped in the tedium of life locked away in a psychiatric hospital? But already you have shown defiance - and I am sure I have taught you by now, if nothing else, that I’ll brook no defiance. You know what comes next, don’t you, girl?”

The ‘girl’ in question did indeed know... the doctor’s cane was the best remedy under such circumstances - or so the doctor always insisted.